Provider Agreement Requirements. (1) The sample copy of a provider agreement for an insurer or managed care plan filed with the commissioner shall: (a) Comply with the requirements of KRS 304.17A-527(1); (b) Comply with the requirements of KRS 304.17A-728; and (c) Not include a: 1. Most-favored nation provision in accordance with KRS 304.17A-560; 2. Limitation on disclosure provision in accordance with KRS 304.17A-530; 3. Condition of participation provision in accordance with KRS 304.17A-150(4); and 4. Mandatory use of hospitalist provision in accordance with KRS 304.17A-532(2). (2) The sample copy of a provider agreement for a limited health service benefit plan filed with the commissioner shall: (a) Comply with the requirements of KRS 304.17C-060(1); (b) Be governed by Kentucky law; and (c) Not include a limitation on disclosure provision in accordance with KRS 304.17C-070.
Appears in 2 contracts
Samples: Provider Agreement and Risk Sharing Agreement, Provider Agreement and Risk Sharing Agreement
Provider Agreement Requirements. (1) The sample copy of a provider agreement for an insurer or managed care plan filed with the commissioner shall:
(a) Comply with the requirements of KRS 304.17A-527(1);
(b) Comply with the requirements of KRS 304.17A-728; and
(c) Not include a:
1. Most-favored nation provision in accordance with KRS 304.17A-560;
2. Limitation on disclosure provision in accordance with KRS 304.17A-530;
3. Condition of participation provision in accordance with KRS 304.17A-150(4); and
4. Mandatory use of hospitalist provision in accordance with KRS 304.17A-532(2).
(2) The sample copy of a provider agreement for a limited health service benefit plan filed with the commissioner shall:
(a) Comply with the requirements of KRS 304.17C-060(1);
(b) Be governed by Kentucky law; and
(c) Not include a limitation on disclosure provision in accordance with KRS 304.17C-070304.17C- 070.
Appears in 1 contract
Provider Agreement Requirements. (1) The sample copy of a provider agreement for an insurer or managed care plan filed with the commissioner shall:
(a) Comply with the requirements of KRS 304.17A-527(1);
(b) Comply with the requirements of KRS 304.17A-728;
(c) Comply with the requirements of KRS 304.12-237, as applicable; and
(cd) Not include a:
1. Most-favored nation provision in accordance with KRS 304.17A-560;
2. Limitation on disclosure provision in accordance with KRS 304.17A-530;
3. Condition of participation provision in accordance with KRS 304.17A-150(4); andor
4. Mandatory use of hospitalist provision in accordance with KRS 304.17A-532(2).
(2) The sample copy of a provider agreement for a limited health service benefit plan filed with the commissioner shall:
(a) Comply with the requirements of KRS 304.17C-060(1);
(b) Be governed by Kentucky lawunder the jurisdiction of Kentucky; and
(c) Not include a limitation on disclosure provision in accordance with KRS 304.17C-070.
Appears in 1 contract
